Dr. Smith's ECG Blog

APRIL 17, 2023

4) There is well formed J-point notching. He also stated he "just didn't feel well" starting about 14 hours prior to presentation, but the chest pain was only noticed about 2 hours prior to presentation. His HEAR score (before troponin resulted) was documented at 3, with documentation stating "low suspicion for ACS."

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

EMDocs

JULY 9, 2024

Insurance companies paying more attention to addressing social needs Medicaid: 1115 Demonstration Waivers, CalAIM in California ICD-10 code modifiers to acknowledge – and compensate—for the added complexity of social needs Additional resources/further reading: Liberman DB, Pham PK, Semple-Hess JE. JAMA Pediatr. 2016 Nov 7;170(11):e162521.

Pediatrics 55

Pediatrics Emergency Department Research Burns 55

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. Visible Proofs: Forensic Views of the Body exhibition at the National Library of Medicine closed on February 25, 2008. California Health and Safety Code 102850-102870.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." Smith comment: But the tests (ECG and troponin) are extremely specific and so the post test probability is nearly 100%. Repeat cTnI drawn at around 8 AM was 3.910 ng/mL. This patient was not one of the lucky 6.4%

EKG/ECG 113

EKG/ECG Documentation/Coding Wellness Emergency Department 113

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Recommendations for sudden infant death syndrome prevention: a discussion document. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull. Bialocerkowski, A.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

PulmCCM

OCTOBER 30, 2023

In 2008, the U.S. And maybe, noticing all the fuss, some clinicians might have started coding for VAP slightly less often in equivocal cases. incidence of VAP has remained stubbornly persistent : though it declined from 20 cases to 15 per 1000 ventilated patients 2008-2015, the rate then crept back up to 17 per 1000 in 2017.

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Don't Forget the Bubbles

MARCH 19, 2024

Just 20% of a person’s health and general well-being is related to access to care and the quality of services. Acknowledging the challenges associated with paediatric social admissions begins with documenting social issues and assessing their social history with the same level of detail as their medical history. Caitlin, A.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

I remember Allie well from her days in the Research volunteer program at Hennepin. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. A repeat EKG was performed at that time and showed this: The STE had almost completed resolved and the STE depression is improved as well. F (rectal).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 52

Advanced Emergency Nursing from AENJ

JULY 9, 2015

Pull out the manikins (or use a volunteer; BVM only) and run some awkward codes! Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. NREMT (2008). December 2008 JEMS Vol. How versatile are your airway skills? Oh, sure, you can handle any supine situations! Gather everyone. Before} 19 May 01.

Airway Management 40

Airway Management Pediatrics Resuscitation Documentation/Coding 40

Dr. Smith's ECG Blog

JULY 22, 2023

The patient did well and was ultimately discharged home. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. As for our patient, on discharge, her EKG had completed returned to her baseline morphology and she has been doing well in follow-up.

EKG/ECG 64

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Wellness 64

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EB Medicine

MAY 3, 2019

Jeff: If those figures seem a bit high, another CDC study found that in a general population survey of a quarter million people between 2006-2008, 9% met the criteria for major depression. The PSS-3 assesses for depression/hopelessness and suicidal ideations in the past 2 weeks as well as lifetime history of suicide attempt.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient did well at least in the short term. Diagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: limitations of ST-segment elevation in standard and extended ECG leads. JACC 51(3):307-14; January 22, 2008. EF was 55%. 418 of these 1788 (23%) had acute coronary occlusion.

EKG/ECG 40

EKG/ECG Seizures Documentation/Coding Outcomes 40

EB Medicine

DECEMBER 1, 2018

Antigen drift refers to small point mutations to the viral genes that code for H and N. Jeff: Of note, EMS providers should use face masks themselves and place them on patients as well. Jeff: Viral culture and RT-PCR remain the gold standard, but both require more time and money, as well as a specialized lab. Nachi: Amazing.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Don't Forget the Bubbles

JUNE 5, 2023

These are the preferable contraceptive choice, so this point appears to have been well communicated in the video. Babies born between March-May 2020 were compared with a historic baseline” cohort of babies (1 629 babies ) born between 2008-2011. This study also demonstrated the usefulness of social media as a research platform.

Outcomes 124

Outcomes Research Wellness Documentation/Coding 124

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 93

Infectious Diseases Administration Sepsis Anaphylaxis 93

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Expiratory airway obstruction may well have been frequently misdiagnosed as it can produce breath-stacking and ball-valve obstruction that impedes any airflow with mask ventilation if neither a nasal nor an oral airway is used and the lips have closed under the mask. Lubricate well. Gerkin] Priceless. Always be gentle! McLachlan, G.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Maria Yang, MD

DECEMBER 21, 2024

These conservatives also maintain that calling for regulation undermines conservatives calls for parental empowerment on education or vaccines as well as personal parenting responsibility. That article was published in 2008, when social media, though common, had yet to hit its peak. or the government?

Psychiatric 40

Psychiatric Research Documentation/Coding Wellness 40